How much suffering is too much when it comes to spring allergies? Anyone who has moderate to severe seasonal allergies knows that when you reach a certain point—when your itchy red eyes, runny nose, and sneezing become overwhelming—you need relief. But, what does relief look like and how do you get there?

“Bottom line, very few people suffer from the same allergies or symptoms,” says allergist Bradley Chipps, MD, president of the American College of Allergy, Asthma and Immunology (ACAAI). “You have to create a personal treatment plan by first avoiding the things you’re allergic to, and then treating your specific symptoms. The question for many people is whether over-the-counter remedies are enough, or if prescription medications are needed.”

According to a new practice guideline from the Joint Taskforce on Practice Parameters, more medications aren’t necessarily the way to go. Nasal steroid sprays are extremely effective and easy to get. They're also relatively inexpensive and don’t have a lot of side effects. They are a good place to start for those over the age of 12, according to the guidelines.

“The guidelines recommend nasal steroid sprays as the first line of defense instead of an oral antihistamine,” says allergist Dana Wallace, MD, past ACAAI president and co-author of the guideline. “The task force didn't find evidence of better results if oral antihistamines were added to treatment along with the nasal steroid sprays. And, oral antihistamines can cause sleepiness.”

For people with moderate to severe seasonal allergies who are older than 12, the guidelines suggest adding an intranasal antihistamine spray to treatment along with a nasal steroid inhaler. The additional medication provides added benefit for those with more severe allergies.

Allergists advise people to start taking medication 2 to 3 weeks before symptoms normally start. According to ACAAI, if you begin your allergy medications before the worst symptoms hit this spring, your suffering won’t be as bad. Although people think spring starts in April, symptoms can begin earlier in warmer areas. Keep in mind when your symptoms normally appear and start your medication well in advance.

Many people go in search of “natural” remedies. They might not know that immunotherapy—in the form of allergy shots and tablets—is a very natural treatment. During allergy shots, you are given gradually larger doses of your exact allergens. The slow increase causes your immune system to become less sensitive, which reduces future allergy symptoms. Allergy tablets—taken under the tongue—are available to treat pasture grasses, ragweed, and house dust mite and, to be effective, must be started 8-12 weeks before the allergy season starts.

Allergies can be challenging to treat, but there’s no reason to lose hope for relief. There are many treatments an allergist can prescribe and/or provide so you can breathe easier. A board-certified allergist is trained in how to identify your allergens and treat your symptoms. They can suggest the most appropriate medications to treat your allergies and asthma. If you think you might be one of the more than 50 million Americans that suffer from allergy and asthma, ACAAI can help you find an allergist in your area.